Lyme disease is an important emerging infection caused by a tick borne spirochete B. burgdorfi (Bb). Originally characterized as an arthritis, it appears that neurologic involvement is also a significant early manifestation of the disease in North America. Neurologic complications of the disease can involve meningitis, facial nerve palsy (or other cranial neuropathy) and radiculoneuritis in early disseminated infection. It is also unclear at what point the infection changes from a localized skin erythema migrans (EM) to an early disseminated syndrome. The objective of this study is to characterize the frequency, clinical correlates and outcome of central nervous system infection in early Lyme disease. The study parameters will include clinical features, immune response, cerebrospinal fluid changes, neurocognitive disturbances, and psychosocial aspects of the disease.